Clinical and histological profile of surgically managed benign adnexal masses

To study the clinical and histological nature of benign adnexal masses managed surgically. A retrospective descriptive study in a teaching hospital in Oman of all the women who had surgical management of benign adnexal masses from January 2008 to May 2012. Data pertaining to age, parity, presenting symptoms, imaging and tumor markers performed and the surgical intervention done on those women with benign adnexal masses was collected from the electronic health records of the patients. There were 198 women during this period operated for benign adnexal masses. The most common benign neoplasm was mature teratoma of the ovary followed by endometriosis. Conservative surgery in the form of ovarian cystectomy was necessary in three fourths of women and in about just less than 50% of women, the procedure was completed laparoscopically. The most common benign tumor was teratoma but laparoscopic approach, which is the standard of care in these women, was possible only in just about 50% of the women

Peer review and audit of morbidity after three or more caesarean sections

A retrospective cohort study was conducted of caesarean sections for women who had previously undergone two or more caesarean section performed by six obstetrician registrars in Sultan Qaboos University Hospital, a tertiary referral hospital in Oman. Retrospective data were collected from electronic health records of 120 Omani women between January 2010 and December 2011 [20 per registrar]. Haemorrhage of more than 1000 ml was recorded in 10% of patients, one patient was found to have a bladder injury intraoperatively, and postoperative wound infection occurred in 5% of patients. Difficulty in opening the abdomen was found in one patient, and one case of deep vein thrombosis occurred despite prophylactic heparinisation. One infant was preterm, and four had intrauterine growth restriction. Intraoperative complications, such as blood loss, visceral injury and long mean operating time and postoperative complications, such as deep vein thrombosis, wound infection and febrile morbidity, were comparable among the registrars. The standard of the registrars was comparable, and similar to international standards

Nitric oxide and antioxidant enzymes in venous and cord blood of late preterm and term Omani mothers

This study assessed the role of oxidative stress in parturition in Omani mothers following growing reports that late preterm neonates were at greater risk than term neonates of perinatal death. Venous blood samples were collected during labour, and cord [neonatal] blood samples were taken after childbirth in late preterm and term from women at Sultan Qaboos University Hospital, Oman. Plasma nitric oxide [NO] concentrations, erythrocyte catalase [CAT]. Erythrocyte glutathione peroxidase [GPx] activities were measured using spectrophotometric Methods. When compared with term mothers, late preterm mothers had markedly higher NO concentrations [micro mol/L] 17.1 +/- 3.3 versus 11.0 +/- 5.5 [P <0.0001], and lower GPx values [U/g Hb] 94.1 +/- 12.9 versus 110.4 +/- 12.3 [P <0.0001]. Late preterm mothers were significantly younger [P = 0.027] than term mothers and had neonates that weighed significantly less [P <0.0001] than term neonates. GPx activity was significantly reduced [P = 0.001] in late preterm neonates as compared to term neonates. CAT showed no change in activity in any comparison. Distinctly higher values of NO and lower GPx activity were found in late preterm mothers relative to term mothers; also, lower GPx in late preterm neonates relative to term neonates suggested a pro-oxidant-antioxidant imbalance due to the greater oxidative burden in late preterm parturition

Fetal macrosomia. Risk factors and outcome

To determine the risk factors predisposing to fetal macrosomia and assess the maternal and perinatal outcome in these patients. This was a retrospective analysis of all macrosomic deliveries in the Department of Obstetrics and Gynecology, Sultan Qaboos University Hospital, Sultanate of Oman, during a 3-year period from January 2001 - December 2003. The maternal and neonatal records of infants with birth weight of >/= 4000 g [n=275] were reviewed. Outcome variables included demographic profile, antenatal risk factors, mode of delivery and maternal and perinatal complications. A total of 7367 deliveries occurred during the study period. The rate of macrosomic deliveries was 3.75% and the rate of deliveries >/= 4500 g was 0.48%. The mean birth weight of the study group was 4230 +/- 220 g. Obesity, diabetes, prolonged gestation and postpartum hemorrhage were significantly higher in the study group. The cesarean section rate was 25.8% for the study group compared to the general incidence of 13.1% during the study period [p<0.0001]. The incidence of shoulder dystocia was 7.6% compared to the general incidence of 0.48% during the study period [p<0.0001]. There were 7 cases of Erb's palsy, all except one recovered without sequelae by 3 months of age. Gestational diabetes, maternal obesity, increasing age and parity were the main risk factors for fetal macrosomia. The incidence of shoulder dystocia, birth injuries and neonatal morbidity increased in this group